Our Views: Expanding Medicaid coverage would provide real benefits to medical providers’ bottom lines

The Advocate

There is a powerful moral case to be made for expanding Medicaid insurance coverage for the working poor in Louisiana.

Too often overlooked is the business case for expansion.

The Baton Rouge Area Chamber has recognized this in its agenda for candidates for governor and the Legislature this fall.

Hospitals and doctors’ offices are businesses, although they have substantial moral and legal obligations to help patients who can’t afford to pay, or pay much. Expanding Medicaid coverage under the U.S. Affordable Care Act would provide real benefits to medical providers’ bottom lines.

The chamber’s statement noted that health care insurance is “a major economic issue.”

“By bringing billions of dollars of federal investment to the state, expanding Medicaid eligibility will bring thousands of jobs and provide coverage for thousands of workers in the capital region,” BRAC said.

We’re delighted that BRAC can make simple calculations that have been obvious for several years but ignored at the State Capitol.

For political reasons, Gov. Bobby Jindal and the Republican-led Legislature have refused to accept ACA money. They didn’t want to be associated with a program associated with President Barack Obama, as if there were some kind of political Ebola attached.

There is also the home truth that while “Obamacare” might be revised or even ended, Medicaid as an existing program is likely to be around a long time — long past Obama’s terms in office.

Yet it’s been true all along that Louisiana would save money in its operating budget if the ACA money had been accepted. Many hospital bills for low-paid workers would be eligible for generous reimbursements from Medicaid; that share of federal participation would stretch state dollars much further.

Under the current ACA deal, the U.S. Treasury would pay 90 percent of eligible bills caused by the expansion. That’s even better than the 65 percent or so that is paid under the existing program. It’s still taxpayer money, but it’s also returning our federal tax dollars to Louisiana.

And as BRAC points out, that helps the bottom lines of hospitals, clinics and physicians across the state.

In Baton Rouge, it’s not at all clear that Medicaid expansion would have provided enough new dollars to avoid the traumatic closure of a Mid-City emergency room this year. But by and large, hospitals would be better off, and the state general fund would be a little bit healthier, too.

The major candidates for governor are either in favor or are willing to look at the ACA expansion. We hope that business groups across the state will emulate BRAC’s common sense and push the candidates to endorse what should have been done years ago, bringing health care to working families on favorable financial terms for the state.

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